In this blog, patient Becky Tatum reflects on two articles in Forbes magazine describing how technology is enabling patient's with multiple chronic conditions who may have been discharged from hospital, to now be provided with aftercare in their own home. Becky looks at the pros and cons of receiving hospital treatment at home from a patient's perspective.
Hospital-level care at home, in the form of remote monitoring and daily visits from medical professionals, is being touted as the potential future of healthcare, saving money and freeing up hospital beds. But as well as the financial considerations, it is important to reflect upon how this approach would feel to you as a potential patient in receipt of this novel treatment approach.
As a patient, the upsides to being treated in your home instead of in hospital are obvious. It saves time and money to not have to travel to the hospital regularly for treatment. You are in the familiar setting and comfort of your own home, which is likely to leave you happier and more relaxed. It’s comforting and gives you peace of mind knowing that family members are nearby. Moreover, you are not restricted to seeing loved ones at set visiting times, which (as we know too well) during the height of the COVID-19 pandemic were (and still are) extremely limited, or in many cases not allowed at all.
Also, it would be less noisy at home compared to being in hospital, with none of the unwelcome sounds from other patients, the nursing station, etc. Another upside is that you don’t have to go to an area where you would mix with others who may have communicable infections, which is always a real risk for immunocompromised patients. From the point of view of the care you receive, the attention of the medical staff is focused fully on you with no distractions, rather than having to see many patients in quick succession, so care is likely to be of higher quality and more personalised.
But, the downsides to such a treatment approach are aplenty. Firstly, being treated in your home is an invasion of personal privacy and removes the boundaried distinction between home and hospital – some patients might want to keep the two domains very separate. Secondly feelings of uncertainty and unsafety may result from not being in a purpose-built medical environment with staff at your call 24/7, promoting worries such as, ‘will medical concerns be picked up soon enough?’ and ‘will staff turn up when they are supposed to?’, to name but two.
There could potentially be a delay in medical intervention in the time it takes for staff to attend the home once an alarm has been raised, especially in rural areas or if weather conditions are bad; this could be dangerous if the patient goes into crisis and rather than call for an ambulance they wait for their community-based carer. There may also be the tendency for more mobile patients to over-do things and be too active in their home environment; simple things like letting the dog out or just making a cup of tea might be too much physical effort compared to the limited self-sustaining activity necessary for people in a hospital bed.
There are practical and social considerations, too. If living independently or in a household where family members aren’t always available, the lack of regular physical support to wash, prepare food, etc, may be an issue – so for some people, medical care would need to be augmented with social care. Even the act of letting staff into the home may be problematic if you have reduced mobility and there is no-one else at home. And, with knowing that (essentially) strangers are continually entering your home, you may feel the need to keep your house tidy at all times, too, which adds extra pressure. It would also be very disruptive for other family members that are present to have staff constantly arrive and depart, invading their personal or work space as well as the patient’s. Then there is the impact on the environment from the various medical professionals driving around to patients’ homes multiple times each day, something the eco-conscious cannot overlook.
Overall, there are pros and cons in being treated in your own home instead of in hospital. Receiving high-acuity care and monitoring in the home environment is promoted by hospitals and insurers as the potential way forward for hospital treatment. But whether this is the future of hospital care or not, crucially needs to take into account the views of the patient, which will always be unique.
About the Author
I am a volunteer for Patient Safety Learning who loves to blog about health and care.